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TO THOSE 

OF THE PAST AND PRESENT 

WHOSE EFFORTS IN ELEVATING AND MAINTAINING 

PHILADELPHIA AS THE WORLD'S MEDICAL CENTRE 

AND WHOSE TIRELESS ZEAL AND ENTHUSIASM 

IN THEIR PROFESSION WILL BE A GUIDE 

TO THOSE WHO FOLLOW, THIS 

BOOK IS DEDICATED 



PHILADELPHIA 

WORLD'S MEDICAL 
CENTRE 



BY WORD AND PICTURE 

THIS BOOK TYPIFIES THE TREMENDOUS GROWTH 

OF PHILADELPHIA'S INSTITUTIONS IN THE FIELD 

OF MEDICAL SCIENCE AND PROVES CON- 

CLUSIVELY ITS RIGHT TO THE TITLE — 

WORLD'S MEDICAL CENTRE 



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MEDICAL GQUJa» 




PHILADELPHIA— World' s Medical Centre 



History of the Outstanding Achievements of 
Philadelphia as a Medical Center 

By JAMES M. ANDERS, M.D., LL.D. 

Emeritus Professor of Medicine, Graduate School of Medicine, University of Pennsylvania 






PHILADELPHIA is the birth- 
place of American Medicine. 
It will not be possible to de- 
pict the development of medicine 
in Philadelphia in epochs, since 
ofttimes the advances have super- 
seded one another almost insen- 
sibly. A tendency toward interna- 
tional professional relationships 
was manifested from the begin- 
ning of medical activities in this 
city, and the scientific spirit, 
which, however, had not yet com- 
menced to burn like a sacred fire 
abroad, was introduced here by 
some of the earliest local physi- 
cians. Indeed, the medical profes- 
sion of the present day cannot, 
upon reflection, fail to feel de- 
voutly grateful to the founders of 
Medical Science in Philadelphia — 
to Griffith Owen, John Kearsley, 
Thomas Cadwalader, John Mor- 
gan, William Shippen, Jr., Thomas 
Bond, Benjamin Rush, Samuel 
Gerhard and others, for the reason 
that they made possible, in no nar- 
row sense, the advantages we en- 
joy today. We must also accord 
grateful veneration to the stand- 
ards set by the Welsh Quaker doc- 
tors who accompanied the colon- 
ists, for to them was largely due 
the advanced professional position 
taken by Philadelphia in its very 
incipiency. 

The first representative of the 
medical profession was Jan Peter- 
sen, a barber of Alfendolft; he was 
surgeon to one of the Swedish 
colonies on the Delaware at a 
salary of ten guilders a month, be- 
ginning July 10, 1638, while the 
first well-known practitioner in 
Pennsylvania was Dr. Griffith 
Owen. As early as 1700, the first 
quarantine law was passed in 
Philadelphia, and the quarantine 
physician for many years was Dr. 
Thomas Graeme. 

In 1717, Dr. John Kearsley as- 
sumed the responsibility of pre- 
ceptor and teacher of young men 



desirous of studying medicine, 
with phenomenal success, due to 
the excellence of the instruction of- 
fered, and not a few of his pupils 
were "destined for prominence in 
the early records of their profes- 
sion in this country." Among his 
pupils it became the vogue to so- 
journ abroad to amplify their 
medical knowledge, presumably to 
obviate the necessity of depending 
upon the mother country for an 
adequate supply of competent 
physicians. Perhaps the earliest of 
these was Lloyd Zachary, who, 
upon returning to Philadelphia 
with Phineas Bond, made it pos- 
sible, by volunteering gratuitous 
service, to execute the plans sug- 
gested by Dr. Thomas Bond to 
Benjamin Franklin, for the estab- 
lishment of the Pennsylvania Hos- 
pital. It is worthy of note that 
Dr. Thomas Cadwalader was the 
first native son of Philadelphia to 
receive his medical education 
abroad; he was the first to make a 
necropsy for scientific purposes 
and the first to employ electricity 
in the treatment of disease — a case 
of paralysis. 

Among the earlier Philadelphia 
physicians, there were numerous 
pioneers other than those already 
mentioned. For example, to Dr. 
Thomas Bond credit is due for the 
first record of lithotomy in Amer- 
ica; the operation was performed 
by him at the Pennsylvania Hos- 
pital in 1756. Dr. William Ship- 
pen, Jr., was before all others in 
teaching obstetrics and to establish 
a private maternity in 1762, as well 
as the first to urge systematic 
medical school education in the 
place of the apprentice system 
then in vogue. He was also the first 
to dissect human bodies, under 
public protest and threats of vio- 
lence and an attempt to destroy 
his house, although serious damage 
was averted. His contemporary, 
Dr. John Morgan, held the same 



view concerning medical educa- 
tion, and, upon returning to Amer- 
ica in 1765 from abroad, took a 
long forward step and founded the 
primary medical school in Amer- 
ica (later the medical department 
of the University of Pennsyl- 
vania), and became the first Pro- 
fessor of the Theory and Practice 
of Physic therein. 

To Morgan belongs the credit of 
effecting a division between medi- 
cine and surgery, feeling that they 
required different types of men. 
Again, it was due in large part to 
his teaching and influence that 
surgery early took an advanced 
position in this city. Surely we 
may look upon the delineation of 
the physician from the surgeon as 
an early outstanding achievement 
in American medicine. Subse- 
quently, obstetrics was adopted as 
the first specialty. The value of 
hygiene and preventive medicine 
was early recognized in Philadel- 
phia. Here should be recollected 
the fact that the control of the 
medical service of the Continental 
Army was almost solely in the 
hands of Philadelphia physicians, 
and the list was truly an epitome 
of the profession of the city of the 
Colonial period. 

A number of valuable methods 
of treatment took origin here in 
that early period, especially in- 
novations in surgical treatment. 
For example, the Bond splint for 
fractures of the lower end of the 
radius, devised by Dr. Thomas 
Bond. To Dr. Philip Syng Physick 
belongs the credit of inventing a 
number of surgical appliances and 
instruments, such as the urethro- 
tome, the seton for ununited frac- 
tures, ligatures for vessels, and a 
tonsillotome. The stomach tube 
for gastric lavage is often ascribed 
to Dr. Physick and was wrought 
out independently by him, al- 
though Dr. Alexander Monro of 
Edinburgh described its use in gas- 



MpES! ■■*4}0!& 



PHILADELPHIA— World' s Medical Centre 



trie lavage as early as 1797. It was 
Dr. John Rhea Barton who intro- 
duced wiring of fragments in frac- 
ture of the patella; Dr. Hugh L. 
Hodge invented a pessary and ob- 
stetrical forceps, and Dr. S. D. 
Gross, a transfusion apparatus, 
foreign-body extractor, bullet 
probe, artery forceps, tourniquet 
and splints. No name looms larger 
in the scroll of fame in Philadel- 
phia medicine than that of Dr. S. 
D. Gross, who, after his demise, 
was honored by the erection of a 
National Statue, a unique distinc- 
tion. Much credit should be given 
to Dr. Atlee for having directed 
the attention of the world to 
ovariotomy as a justifiable pro- 
cedure in given conditions. 

During the closing period of 
the War of the Revolution, the 
population of Philadelphia was 
approximately 40,000, of whom 50 
were physicians. Among those who 
helped to advance Philadelphia 
medicine by means of institutional 
and practical measures still oper- 
ative was Samuel Powell Griffith, 
who was born in this city in 1759. 
It was to him that Benjamin Rush 
suggested the founding of the Col- 
lege of Physicians, of which he 
later became one of the founders 
and was Vice-President at the time 
of his death in 1826. Dr. Griffith 
was one of the founders of the 
Philadelphia Dispensary (in 
1786), the first institution of its 
kind in America. He was also one 
of the founders of the Friends 
Asylum in Frankford, and at the 
early age of thirty years was ap- 
pointed Professor of Materia 
Medica and Pharmacy in the first 
Medical School. 

No history of the achievements 
of Philadelphia medicine would 
be complete without reference to 
Benjamin Rush, conceded to have 
been one of the greatest clinicians 
this country has ever produced 
and styled by Lettson the "Syden- 
ham of America." Besides bein»; 
an acknowledged leader in prac- 
tical medicine, he was an essayist 
in many lines, an orator, investi- 
gator, a scholar, statesman, phil- 
osopher, scientist, a highly success- 
ful teacher and a Christian gentle- 
man. Among his pupils were many 
men who added luster to the rep- 
utation of Philadelphia as a 
medical center. For example, Dr. 



Philip Syng Physick, a Philadel- 
phian, previously mentioned, who 
has been called the father of 
American surgery; also Dr. John 
Redmond Coxe, the founder of 
medical journalism in America, 
and the first subject to be success- 
fully vaccinated in Philadelphia. 

To Dr. Thomas E. James goes 
the credit of first opening lying-in 
wards in the Pennsylvania and 
Philadelphia hospitals. The first 
medical text-book in America was 
published by a Philadelphian, Dr. 
Caspar Wistar, whose anatomical 
specimens form the nucleus of the 
present Wistar Museum of the Uni- 
versity of Pennsylvania. An event 
worthy of mention was the found- 
ing of the first medical journal in 
America, the Philadelphia Medical 
and Physical Journal (1804-09). 
In 1820 Nathaniel Chapman 
founded the Philadelphia Journal 
of the Medical and Physical Sci- 
ences; in 1827 he started a new 
series of this journal under the 
title "American Journal of the 
Medical Sciences," which has been 
the best of the American monthly 
medical periodicals. 

Subsequently, the supreme dom- 
inance of the individual physician 
ceased for all time, and collective 
effort, which had its origin first 
with Morgan and his associates 
and later many former pupils of 
Rush, now became the established 
rule, and as knowledge grew, the 
tendency toward specialism in- 
creased. This fact explains the 
multiplication of schools and pri- 
vate institutions during the latter 
part of the eighteenth and the 
first half of the nineteenth century. 

Among the greatest exponents 
of scientific medicine of that pe- 
riod, the following are deserving 
of special mention: William P. 
Dewees, William E. Horner, Rob- 
ert E. Hare (the inventor of the 
oxyhydrogen blow-pipe in 1801), 
George B. Wood, Samuel Jackson 
and William W. Gerhard, the 
greatest pathologist of this day, 
whose paper on differential diag- 
nosis of typhus and typhoid fevers 
in 1837 definitely settled the clin- 
ico-pathologic status of the two 
diseases. The founding of the Path- 
ological Society of Philadelphia in 
1838, by Norris, Pennock, Stille, 
Goddard, Pepper, Mutter, Carson, 
and others, was an event of much 



importance. The present Patho- 
logical Society, however, was or- 
ganized in 1857 in the old "picture 
house" of the Pennsylvania Hospi- 
tal, where an address was delivered 
by the late Sir William Osier on 
the occasion of its Fiftieth Anni- 
versary. 

Among other men who left their 
lasting impress upon Philadelphia 
medicine, at a somewhat later 
date, were: Dr. George McClellan, 
the founder of Jefferson Medical 
College in 1825; Dr. Robley Dun- 
glison, who, while teaching six 
branches of medicine simultan- 
eously in the University of Vir- 
ginia, published a work on human 
physiology, a medical dictionary, 
and a work on therapeutics, and 
later occupied the chair of Insti- 
tutes of Medicine in the Jefferson 
Medical College for thirty-two 
years; Dr. Ann Preston, who re- 
organized the Woman's Medical 
College of Philadelphia, and Dr. 
George P. Oliver, who organized 
the Medico-Chirurgical College. 

Medical schools of low standard 
and short courses requisite for the 
degree of Doctor of Medicine in- 
vited opprobrium, and these con- 
ditions were directly responsible 
for the origin of the American 
Medical Association, designed as a 
moral uplift to secure a better state 
of medical ethics and service in 
the land. The first National Con- 
vention was held in New York in 
1846, with only one Philadelphia 
School to join in the movement, 
namely, the Medical Department 
of the Pennsylvania College, one 
of the two schools founded by Dr. 
George McClellan. 

"In the following year, repre- 
sentatives of 28 medical colleges 
and 40 medical societies assembled 
in Philadelphia. A report on 
medical ethics was submitted, and 
a plea for higher educational re- 
quirements was made to the col- 
leges. Dr. Nathaniel Chapman of 
the University of Pennsylvania was 
the first president, Dr. Alfred 
Stille, one of the two secretaries, 
and Dr. Isaac Hays, treasurer. All 
of these men, be it observed, were 
Philadelphians." 1 Philadelphia, 
therefore, may be said to have 
been the birthplace of the Amer- 
ican Medical Association. 



1 Founders* Week Memorial Volume, p. 54. 



PHILADELPHIA— World' s Medical Centre 



This movement resulted in the 
stimulation of the local profession 
to better things, and also led to the 
organization of the Philadelphia 
County Medical Society on Janu- 
ary 16, 1849, which Society has 
done so much to promote medical 
progress in Philadelphia. At that 
time the city proper of Philadel- 
phia lay between the Delaware and 
the Schuylkill Rivers, and Vine 
and South Streets, and its popula- 
tion was 120,000, while the popula- 
tion of the entire county, which in- 
cluded various districts and town- 
ships, such as Frankford, North- 
ern Liberties, Kensington, Moya- 
mensing, Southwark, West Phila- 
delphia and so on, was about 400,- 
000. As stated by J. Chalmers Da 
Costa 2 this city was then "the 
medical center of the country, its 
medical authorities were revered 
far and wide, and every ambitious 
medical man in the United States 
looked towards a chair in a Phila- 
delphia college as the crowning 
point of his career." The Hahne- 
mann Medical College and Hospi- 
tal of Philadelphia, the first Home- 
opathic Medical School in this 
country, was organized in 1848 by 
Dr. Constantine Hering, Dr. Jacob 
Jeanes and Dr. Walter Williamson. 
It may be justly claimed that Phil- 
adelphia was the pioneer in medi- 
cal education for women, the 
Woman's Medical College being 
organized in 1850. The second 
children's hospital was established 
in 1855 in Philadelphia, the first 
having been organized in 1851, in 
New York. 

The founders of The Philadel- 
phia County Medical Society and 
those counted among its earliest 
members visualized in outline the 
plan of organization of the medi- 
cal profession, subsequently 
adopted by the American Medical 
Association. They passed a resolu- 
tion calling for the admission of 
delegates from county and state 
medical societies to the American 
Medical Society — a plan subse- 
quently adopted by the national 
organization. The Society also be- 
came actively interested at once in 
professional and public welfare, 
showing that the members were 
endowed with no blunted sense of 
proportion and relative values in 

8 ?5th Anniversary. The Philadelphia County Medi- 
cal Society, p. 79. 



the sphere of medical organiza- 
tions. Among accomplishments 
worthy of notice which we owe to 
the County Medical Society are: 
The advocacy of members famil- 
iarizing themselves with the 
United States pharmacopoeia and 
also adhering to it strictly in their 
prescriptions. On the other hand, 
connection with, or moneyed in- 
terests in, apothecary stores of 
physicians, the Society thus early 
discountenanced. 

Notwithstanding the fact that 
the physician was at that time to- 
tally without modern laboratory 
aids and instruments of precision, 
we owe many achievements of note 
to his ingenuity, versatility and 
highly cultivated powers of ob- 
servation. Among those who con- 
tributed most largely to Philadel- 
phia medicine in the period were: 
Doctors George B. Wood, John K. 
Mitchell, the first to describe 
neurotic spinal arthropathies in 
1831, Nathaniel Chapman, a 
student of Rush and Abernethy in 
London, Charles D. Meigs, Joseph 
Pancoast, famous both as teacher 
and operator, Thomas D. Mutter, 
Samuel Jackson, John Rhea Bar- 
ton, William E. Horner, Robert 
Hare, George W. Norris and many 
others. The movement to reform 
and advance medical education to 
higher standards in this country 
was inaugurated by three members 
of the local medical profession, 
namely, Doctors William Pepper, 
Horatio C. Wood and James Ty- 
son, in co-operation with Elliott of 
Harvard, Sir William Osier and 
William Welch of Johns Hopkins. 

The College of Physicians of 
Philadelphia was founded in 1787, 
it being the third Medical Society 
to be formed in Philadelphia, the 
first being the Philadelphia Medi- 
cal Society, which continued in ex- 
istence only until November 11, 
1768, and the second, the Ameri- 
can Medical Society founded in 
1773, by medical students attend- 
ing lectures in Philadelphia. The 
prototype of the College of Physi- 
cians was doubtless the Royal Col- 
lege of Physicians of London. Its 
organization, however, was agi- 
tated as early as 1767, by Dr. John 
Morgan, but strenuously opposed 
by one of the proprietors, Thomas 
Penn, and this resulted in the 



abandonment of the project until 
1787. 

The work of the College stood 
out conspicuously during the first 
half century of its life, since few 
societies existed during that pe- 
riod. It was then frequently called 
upon to express its opinon and 
rendered valuable aid to the City, 
State and Nation. The College can 
boast of a library second in size 
only to that of the Surgeon Gen- 
eral at Washington, D. C; it has 
been of unlimited service in 
extending the treasures of it col- 
lection of bound journals and 
standard works to thousands of 
physicians and students. The Col- 
lege has ever protected the inter- 
ests of science and taken a firm 
stand in favor of experimental 
medicine, and on more than one 
occasion thwarted attempts at en- 
croachments on the right to use 
animals for purposes of vivisection 
under proper and humane super- 
vision. For many years it gave in- 
terested attention to the subject of 
quarantine. 

The College of Physicians has 
been intimately associated with 
the developmental history of our 
city, and its founders clearly rec- 
ognized the true relationship of 
medicine to the public health. 
Later on it became less active in its 
relation to the domain of sanitary 
science and preventive medicine. 
More recently, however, it has 
been availing itself of opportun- 
ities to promote the health and 
well-being of the general public 
through the establishment of a 
standing committee on Public 
Health and Preventive Medicine 
and also the formation of a section 
covering the same field, including 
industrial medicine. The College 
is now prepared to play an im- 
portant role in the future preserva- 
tion of the health of the commun- 
ity. 

To sketch the history of The 
Philadelphia General Hospital 
would not be possible within the 
limitations of this article, but 
many of the scientific contribu- 
tions to various departments of 
medicine by its visiting and teach- 
ing staffs, including not a few orig- 
inal discoveries, have become his- 
toric classics. The words of Dr. 
Charles K. Mills, 5 written in 1890 



Philadelphia Hospital Reports. Vol. I, pp. 80-81 



■■"' ^ :r '- 



I 



■ ■■ . ■ •■■ ■ . ■■ ■• ■• 



8 



PHILADELPHIA— World' s Medical Centre 



—"On pathology the hospital has 
furnished contributions without 
number and some of great value, 
particularly during the last fifteen 
years" — are even more true of the 
intervening period of forty years 
to date. Unquestionably, this in- 
stitution has been an outstanding 
factor in the progressive develop- 
ment of Philadelphia medicine. 
As stated by the late Dr. D. Hayes 
Agnew: 4 "It is difficult to over- 
estimate the importance of this 
Institution, to either the profession 
or the community." The Philadel- 
phia Pathological Society has in- 
creasingly drawn from this hospi- 
tal for its material. 

An outstanding landmark in 
Philadelphia medicine was the en- 
dorsement of the efforts of medical 
authorities to widen the scope and 
functions of the Division of Child 
Hygiene (in 1914), whose accom- 
plishments in safeguarding the 
lives of infants and young children 
have been distinctly noteworthy. 
Here may be stated the fact that 
during the past two decades there 
has been a sympathetic co-opera- 
tion between the medical organiza- 
tions of Philadelphia as repre- 
sented by our Philadelphia County 
Medical Society and the College of 
Physicians, and those who have 
represented the citizens in public 
health work, and from this close 
co-operation have sprung influ- 
ences that have greatly assisted the 
Department of Public Health in its 
efforts to improve the sanitary 
status of Philadelphia and prevent 
communicable diseases. 

The recent establishment of a 
creditable working and reference 
library by the County Medical So- 
ciety may be viewed as an achieve- 
ment fraught with great possibil- 
ities for the advancement of the 
future scientific interests of the So- 
ciety. The birth of the Weekly 
Roster, founded by Dr. A. B. 
Hirsch, marked a step in advance, 
inaugurating, as it did, meeting 
notices of all Philadelphia's Medi- 
cal Societies, together with ab- 
stracts of papers and additional 
items of interest to the medical 
profession. Among notable 
achievements may be appropri- 
ately mentioned the Volunteer 
Medical Service Corps, founded by 
Dr. William Duffield Robinson and 



* History of Blocfcley, Croskey, p. 3. 



his associates, during the World 
War. This organization was devel- 
oped numerically until it became 
the largest in the world (about 74,- 
000 men) up to Armistice Day. 

The organization of the Gradu- 
ate School of Medicine (formerly 
the Medico-Chirurgical College 
and Hospital) by the University of 
Pennsylvania in 1916 constitutes 
a real landmark in the progress 
and development of medical teach- 
ing in Philadelphia. The prime 
object was to provide a compre- 
hensive series of long systematic 
graduate medical courses, with a 
view to preparing acceptable grad- 
uates to begin special medical 
practice, or teaching, and to stim- 
ulate productive research in medi- 
cine. Its faculty consists of a large 
group of Philadelphia clinicians, 
representing twelve major clinical 
departments. Certificates and de- 
grees are awarded to successful 
regular course student physicians. 
To approved students there is of- 
fered a wide range of opportun- 
ities in their chosen fields of medi- 
cal science. The Graduate School 
of Medicine of the University of 
Pennsylvania, it may be reason- 
ably claimed, has led all other in- 
stitutions in the land with similar 
aims. 

It remains for me to speak of 
the achievements of men, most 
of them no longer in the flesh, 
who have contributed mightily 
to the development of practical 
medicine, not only in Philadel- 
phia, but throughout the world. 
Of these I would make special 
mention of Dr. S. Weir Mitchell, 
poet and novelist, author of "The 
Rest Cure for Nervous Disorders;" 
Sir William Osier, the illuminator 
of internal medicine by his mas- 
terly work; Dr. Joseph Leidy, the 
world-famed naturalist, who dis- 
covered, in 1847, the intermediate 
host of the trichina, namely, the 
hog; Dr. J. M. Da Costa, the mar- 
velously acute diagnostician, au- 
thor of classic contributions to the 
knowledge of cardiac derange- 
ments; Dr. Horatio C. Wood, 
founder of clinical pharmacology, 
or modern system of rational sci- 
entific therapeutics; Dr. William 
Pepper, untiring worker for a 
higher standard in medicine*, au- 
thor of many excellent published 
works, the first to aspirate for 



pleural effusion in America; Dr. 
W. W. Keen, pioneer in brain lo- 
calization and surgery; Dr. Louis 
H. Duhring, founder of American 
Dermatology; Dr. C. E. de M. 
Sajous, the father of Endocrinol- 
ogy; Dr. Joseph Price, nestor of 
abdominal surgery in America; 
Dr. William L. Rodman, famous 
for breast amputations. Among 
many others whose names should 
be recorded here are; Dr. John B. 
Deaver, a renowned specialist in 
appendicitis and surgery of the 
upper abdomen; Dr. George E. 
Pfahler, noted X-ray Therapeutist; 
Dr. William G. Spiller, first to ad- 
vocate operation for tic douloureux 
(1898); Dr. Francis X. Dercum, 
the first to describe adiposis dolo- 
rosa; Dr. Thomas G. Morton, au- 
thor of Metatarsalgia; Dr. L. Web- 
ster Fox the brilliant operator on 
the eye; Dr. John A. Kolmer, Was- 
serman and other Researches; Drs. 
Shamburg and Rawiss, who gave 
us "Arsphenamin;" Dr. B. B. Vin- 
cent Lyon, gall bladder drainage; 
Dr. George E. de Schweinitz, world 
famous Ophthalmologist; Dr. W. 
Wayne Babcock, pioneer in spinal 
anesthesia and others. Dr. Joseph 
Price, a pioneer in modern asep- 
sis, which hastened the surgical 
triumphs in the fields of gynecol- 
ogy and obstetrics; Dr. J. H. Mus- 
ser, who first recognized typhoid 
cholecystitis as a pathologic basis 
of a relapse in typhoid fever; Dr. 
J. Solis-Cohen, the pioneer laryn- 
gologist and advocate of a present- 
day recognized operation for car- 
cinoma of the larynx; Dr. E. E. 
Montgomery, the first to advocate 
the interval operation in appendi- 
citis, and Dr. Thomas H. Fenton, 
the founder of the American So- 
ciety of Tropical Medicine. 

It should be the pride of the lo- 
cal medical profession that Phila- 
delphia has led all other cities of 
the Union in the tuberculosis cru- 
sade. The magnificent Phipps In- 
stitute, the Department of Public 
Health, and the Philadelphia 
Health Council and Tuberculosis 
Committee, have unitedly made a 
most impressive showing in hu- 
manity's fight against this dreaded 
disease. The Philadelphia Heart 
Association and the Children's 
Heart Hospital are together achiev- 
ing practical results quite worthy 
of mention here. 



f 1 



PHILADELPHIA — World's Medical Centre 



Within the period of time of 
those living the most notable prog- 
ress in medicine of all times has 
taken place, and not a few of the 
men who made this progress pos- 
sible have been residents of Phila- 
delphia; they are a part of a long 
legiance to the great masters and 



line of investigators, specialists, 
physicians and surgeons who have 
adorned their profession. 

Philadelphia's traditions are an 
inspiration to the present genera- 
tion, and whilst we owe filial al- 
movements of the past, we must 

(^rs 



also concern ourselves with the 
present and the future; and to this 
end we must set high standards in 
the profession, and with sustained 
earnestness of purpose provide for 
the advance of theory and prac- 
tical achievement in the days to 
come. 



A Brief History of The Philadelphia County 

Medical Society 



By JAMES M. ANDERS, M.D. 
PHILADELPHIA 



1 Abstract, History of the Philadelphia County Medical Society. 
Seventy-fifth Anniversary, The Philadelphia County Medical Society. 



I HAVE been requested 
by the President for the 
year, 1924, Dr. F. Hurst 
Maier, and the Board of 
Directors, of The Philadel- 
phia County Medical So- 
ciety to relate briefly its 
history. This society was 
organized in 1849 and re- 
cently observed its 75th an- 
niversary celebration. Its 
founders were men of hia;h 
standing in the profession, 
and the list included such 
well-known names of doc- 
tors of that day, as George 
B. Wood, Joseph Pancoast, 
Isaac Parrish, Alfred 
Stille, George W. Norris, 
Joseph Carson and others 
equally renowned. It is of 
interest to note that some 
of these men are still alive 
in the memories of many 
living persons. The society 
grew and before the end of 
the fifth year it numbered 
upwards of 200 members. 
The membership subse- 
quently fluctuated, but 
since the year 1900, the en- 
rollment has shown leaps 
and bounds, until now it is 
well above the 000 mark. 
Included in the member- 
ship of this society have 
been, and are, practically 
all of the leading medical men and 
women of the city. 




SAMUEL JACKSON, M.D. 

First President of The Philadelnhia County Medical Society, 

1848-1852 



One of the main objects of the 
County Medical Society has been, 



from the beginning, the 
advancement of our 
knowledge of the causes, 
nature and treatment of 
human diseases, so as to 
better prepare the doctors 
to care for the sick. The 
society has been no less 
active and zealous in its 
efforts to prevent disease 
and to promote the health 
and welfare of the com- 
munity. In this field of 
public health work, it has 
always sought to co-oper- 
ate with the Department 
of Health of the city, now 
so ably headed by Dr. 
Wilmer Krusen. 

Back in 1849, when this 
society was only a few 
months old, it became ac- 
tive in the promotion of 
matters of public interest. 
As the result of resolutions 
then passed by the society 
and the agitation which 
took place subsequently, 
the present law providing 
for the registration of 
births, marriages and 
deaths was enacted. While 
still in its swaddling 
clothes, the County Medi- 
cal Society had its Commit- 
tee on Public Hygiene 
which reported on its own 
activities in the interests of the 
public health from time to time. 



r.r^'j'ci'lSPf*^ 



10 



PHILADELPHIA— World' s Medical Centre 



Again, on April 17th, 1849, just 
three months after its birth, the 
Society urged the legislature of 
Pennsylvania to grant to each 
county in the State, provision for 
the general practice of vaccination 
against smallpox. At various times 
since then, when smallpox pre- 
vailed, e g., in 1900, 1901 and 
again in 1903, general vaccination 
was strongly urged in a series of 
resolutions passed by this society. 
A committee of the society, com- 
posed of Drs. S. Weir Mitchell, 
Wm. M. Welch and Richard Clee- 
man, was instrumental in prevent- 
ing the passage of an anti-vaccina- 
tion measure, introduced in the 
legislature of Pennsylvania during 
the session of 1898-1899. Strangely 
enough, not a few persons are at 
the present writing opposed to vac- 
cination, which is the only known 
certain means of preventing small- 



pox. We have a compulsory vac- 
cination law in Pennsylvania, 
which these misguided persons 
will, it is believed, attack during 
the coming session of the legisla- 
ture at Harrisburg, with a view to 
repealing it. May God preserve the 
citizens of Pennsylvania from such 
a calamity as they would precipi- 
tate, if successful ! 

We have a Medical Legislative 
Committee in Pennsylvania, of 
which an officer of this society, Dr. 
George A. Knowles, is chairman. 
This body, with the aid of the 
strong moral support of the Col- 
lege of Physicians, which recently 
adopted resolutions protesting 
against any change in the com- 
pulsory vaccination law, as well as 
of other professional organizations 
throughout the State, will, it is 
confidently believed, preserve this 
law without change. Dr. W. W. 



Keen, that world-famed and ven- 
erable surgeon, has volunteered to 
go to Harrisburg, if his services 
should be needed, and help to con- 
vince our legislators that the pres- 
ent compulsory vaccination law 
must remain in force. 

Through the labors of a special 
committee of this society, ap- 
pointed in 1903, to report on 
means to prevent the spread of 
contagious diseases, many regula- 
tions were proposed and afterward 
adopted by the Department of 
Health, some of which are in force 
today. The citizens of Philadel- 
phia have long owed a debt of 
gratitude to the Countv Medical 
Society for its real concern for 
their health and happiness, as 
shown by the moral support it has 
ever given to the health depart- 
ment of the city. 




HOME OF THE PHILADELPHIA COUNTY MEDICAL SOCIETY 

Southeast Corner Twenty-first and Spruce Streets 



PHILADELPHIA— World's Medical Centre 



11 



After a single year of active life, 
or seventy-four years ago, this so- 
ciety urged the laying out of pub- 
lic parks in the more crowded sec- 
tions of the city, with a view to 
lessening infantile diseases during 
the warmer months. Indeed, Phila- 
delphia is indebted to this society 
for some of its earliest parks, e. g., 
that at Lemon Hill, a public 
square in Kensington, and another 
in Southwark. The society at this 
early date (1850) urged the invest- 
ing of the city with entire control 
of nearly a mile of the river front 
north of Fairmount Dam — a 
timely action having for its object 
an improved water supply for the 
city. These pioneers in medical 
organization work seemed to visu- 
alize and labor for many of the 
things we are striving to accom- 
plish at the present day, in the 
interests of the people. 

I shall, for want of time, merely 
mention some additional official 
acts of the County Medical Society 
for the benefit of the general pub- 
lic. In 1859, Councils was shown 
the vital importance of preventing 
by law or ordinance the future 
burying of the dead in the closely 
built-up portions of the city. A lit- 
tle later, a successful movement 
was started by this society to pro- 
tect the public against important 
diseases, by suitable quarantine 
laws. In May, 1897, the society 
endorsed Act 536, which was 
aimed to prevent the erection of 
very tall buildings in cities of the 
first class, on account of their ill 
effect upon health. This question 
of the height of buildings, many 
of us think at the present day, 
should be regulated by an appro- 
priate zoning ordinance. In Janu- 
ary, 1898, this society sent a com- 
mittee to Mayor Ashbridge and 
Councils to urge the nitration of 
the water supply of Philadelphia, 
in view of the city's responsibility 
for the prevention of typhoid 
fever; and it was also instrumental 
in starting the Division of Child 
Hygiene of the city's Department 
of Health. 

In 1873, before the germ of 
typhoid fever was discovered, it 
investigated the question of the 
relation of the milk supply to 
typhoid fever during the previous 
year, and also endeavored to as- 



certain what regulations existed 
for insuring the purity of milk, 
just as it had previously done, as 
regards the drinking water supply. 
Recently a standing committee of 
which Dr. O. H. Petty is chairman, 
was appointed to urge all citizens 
to visit their physicians at least 
once each year for a physical ex- 
amination. It is not possible for 
any one, however intelligent, to 
discover in himself or herself cer- 
tain ailments before damage that 
cannot be remedied has occurred. 
And not to have children exam- 
ined annually, with a view to de- 
tecting physical defects and latent 
complaints is, to say the least, in- 
excusable in the present state of 
our knowledge. A universal re- 
sponse to the appeal of this com- 
mittee would save many lives, not 
to speak of the prevention of an 
enormous economic loss, which is 
now taking place, on account of 
human illness. 

In 1873, Dr. Goodell urged the 
society to recommend condensed 
milk, condemning cow's milk 
churned by hauling over the 
streets of Philadelphia, which were 
then paved with cobble stones. At 
the present time, however, on ac- 
count of better paved streets and 
improved dairy sanitation, as well 
as a pasteurized milk supply, the 
use of cow's milk is advocated as a 
rule. 

In 1874, the society, by a resolu- 
tion of Dr. Samuel D. Gross, in- 
vited "the medical brethren of the 
world, to assemble in medical con- 
gress in Philadelphia on July 4, 
1876." This important congress 
was held and was presided over by 
Dr. Gross. Recently, the society 
appointed a special committee to 
convene a National congress in Phil- 
adelphia in 1926, during the ses- 
qui-centennial celebration, and it 
is believed that the proposed 
congress will once more give our 
society a truly national signifi- 
cance. It is pretty certain that 
the members of this body will 
show interest and enthusiasm, and 
it may be safely prophesied that 
they will aid materially to make 
the sesqui-centennial celebration a 
creditable affair. 

Following the semi-centennial 
celebration of the County Medical 
Society in 1900, its work and activ- 



ities rapidly expanded and new 
members were added in large num- 
bers until at the end of the year 
1919, there were only about 200 
physicians in Philadelphia, who 
neglected to join the society, either 
through indifference or owing to 
the expense it would incur, ac- 
cording to Dr. Stahl, who was then 
its President. 

The medical profession was 
formerly opposed to the female 
physician, but by and by "woman 
had her way, as usual," and in 1888 
Dr. Mary Willets was elected to the 
society. How different the attitude 
of the profession toward the fe- 
male doctor at the present day; 
she is welcomed and respected 
everywhere. 

During the World War, this so- 
ciety displayed a truly patriotic 
spirit, the members offering them- 
selves by a unanimous vote for 
service in any field into which they 
might be called. 

In 1923, the society established 
a permanent office in charge of the 
Executive Secretary, Mr. Franklin 
M. Crispin, at 2046 Chestnut 
Street, while its meetings have 
been, for many years, held in the 
College of Physicians. 

In concluding, I trust that my 
hearers have been impressed with 
the many official actions taken by 
The Philadelphia County Medical 
Society to promote human welfare 
and public health measures in par- 
ticular. While I have stressed the 
earlier achievements, the society's 
efforts in the interests of the pub- 
lic have been even more notable 
in recent years, and today an un- 
usually large body of loyal, promi- 
nent members are bearing the bur- 
den of the society's ever-increasing 
activities. 

On October 13, 1924, The Eve- 
ning Bulletin of this city had this 
to say about the County Medical 
Society : 

"Through a standing committee 
on 'Public Preventive Medicine' it 
now aims to keep the public in- 
formed in public health topics, 
advise the city in matters of mu- 
nicipal hygiene and secure the co- 
operation of the physicians to that 
end. Throush sectional branches, 



tpTB) -~0*»M 



12 



PHILADELPHIA— H^or/rf' 5 Medical Centre 



in various districts of the city, it 
maintains also a neighborhood and 
local interest, enabling special 
studies of district problems to be 



made, and, although its general 
concern is the elevation of the 
ethics and practice of the profes- 
sion and the increase of its works, 



the public spread of its activities 
makes the 'County Medical' much 
more than a mere professional as- 



sociation. 



-(L/TS)- 



Philadelphia General Hospital 



By JOHN WELSH CROSKEY, M.D. 
PHILADELPHIA, PA. 



WHEN William Penn sailed 
for America, on the ship 
Welcome, he left a letter 
addressed to his wife and children, 
in which he said: "Pity the dis- 
tressed and hold out a hand of 
help to them; it may be your case; 
and as you mete to others God will 
mete to you again." The "Friends" 
who came with Penn to this 
country, which was to be the 
"haven of rest for the oppressed 
of all nations," were no doubt men 
of sterling qualities; they believed 
in the sentiments expressed in the 
letter left by Penn with his wife 
and children. It is, therefore, not 
surprising that the first almshouse 
established in the Colonies was 
that of the Friends. A few years 
after the landing of Penn, in 1684, 
he conveyed to one John Martin, 
a tailor by trade and a member of 
the Society of Friends, two city 
lots, each 51 feet by 260 feet on 
the south side of Walnut Street, 
between "Delaware, Third and 
Fourth Streets." John Martin died 
in 1702, leaving his two city lots to 
the Monthly Meeting of the So- 
ciety of Friends, expressing the 
wish that they should be disposed 
of in any way the Monthly Meet- 
ing saw fit, for the use of poor 
members of the Society of Friends. 
The Monthly Meeting accepted the 
gift, and eleven years later, 1713, 
when the need of a House of 
Refuge for poor and aged Friends 
became evident, decided to use 
"John Martin's lots on Walnut 
Street" as a site for an almshouse. 
Accordingly, on the rear of the lot 



fronting on Willing's Alley, the 
Monthly Meeting built several 
stone cottages as a place of resi- 
dence for impoverished members 
of the society, and sixteen years 
later, in 1729, built a larger build- 
ing on the Walnut Street front, 
which became known for over a 
hundred years after as the Friends' 
Almshouse. This lot was laid out 
with stone cottages on each side 
and flower beds down the center, 
with several large shade trees on 
the Willing's Alley front, and for 
over a century poor members of 
the society were permitted to re- 
side there rent free with a weekly 
allowance for food, fuel and cloth- 
ing. Those of them who were able 
to supplement their weekly allow- 
ance by working at some trade or 
handicraft were permitted to do so. 

In 1841 the Monthly Meeting, 
having made other provision for 
many of its poor members, demol- 
ished the building on Walnut 
Street front and built a three-story 
office building on the site. The 
stone cottages in the rear, however, 
were still preserved and for thirty- 
five years served the purpose for 
which they were built. Entrance 
to them was given through Will- 
ing's Alley or through a gateway 
on the Walnut Street front. In 
1876 all of the buildings were de- 
molished and the present office 
building built on the site. The 
almshouse lot is mentioned in half 
a dozen deeds from 1731 to 1902, 
but always as being conveyed by 
trustees or substitute trustees of 



the Society. The lot has never left 
ownership of the Society of 
Friends once it was bequeathed in 
1702 by the will of John Martin 
until when it was purchased in 
1924 by the Maryland Casualty 
Company as a site for a large office 
building to be devoted to insur- 
ance interests. 

This Quaker Almshouse was 
strictly sectarian, and none but 
members of the Society of Friends 
were received within its walls. It 
had but few inmates, as the 
Quakers were generally thrifty and 
economical and did not have to be 
supported in an almshouse. A few 
old women were there, and it was 
frequently called the "Quaker 
Nunnery." 

This almshouse or hospital did 
not provide for the idle persons 
who came drifting in among the 
early settlers. Sickness and mis- 
fortune overtaking them, they re- 
quired assistance from the more 
fortunate. This was rendered pri- 
vately, until it became so burden- 
some to a few, that it was deemed 
essential to have some public way 
of relieving the necessities of the 
unfortunate, and to levy an equal 
tax on all to provide the means 
for that purpose. Tramps were not 
encouraged and idleness was not 
considered good form in those 
days. 

In 1713 Council passed a resolu- 
tion which declared: The poor of 
the city, "Dayly increasing, it is ye 
opinion of this Council that a 



PHILADELPHIA— World's Medical Centre 



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14 



PHILADELPHIA— World' s Medical Centre 



i 



~ 



workhouse be immediately hired 
to Imploy poor P'sons and suffi- 
cient P'sons appointed to keep 
them at work." 

In 1717 an order was issued com- 
pelling all receiving relief from 
the Overseers of the Poor, to wear 
upon the right sleeve of the outer 
garment the Roman letter P, to- 
gether with the initials of the 
county or place of which the 
pauper was an inhabitant. 

In 1729 the Overseers of the 
Poor presented a memorial to the 



Assembly which explained the dif- 
ficulty of providing for the great 
number of poor persons from 
foreign ports and neighboring 
provinces, as well as for the insol- 
vent debtors, their wives and chil- 
dren. The city recommended the 
application for relief, and the 
Legislature resolved to "loan the 
Mayor and Commonality one thou- 
sand pounds, to be applied to the 
purchase of ground and erection 
of an Almshouse or Hospice for 
the use of the poor of the city." 



The money was received in 1730, 
and the Mayor, Alderman Plum- 
stead, and James Steel were" ap- 
pointed a committee to select a 
place, prepare plans and make 
estimate. 

A square of ground, known as 
the Green Meadow, bounded by 
Third and Fourth, Spruce and 
Pine Streets, was bought from 
Alden Allen, for two hundred 
pounds, and a brick building was 
erected in 1731 or 1732 known as 
the Philadelphia Almshouse, 







1 









An aerial view of the new $4,000,000 Philadelphia General Hospital which replaces the ancient 

"Blockley" at Thirty-fourth and Pine Streets. The new group of buildings, modern in 

every way, is the outgrowth of a group built in 1831, which in turn sprang from the 

old Philadelphia Almshouse erected at Third and Pine Streets in 1732. 



X 



PHILADELPHIA— World's Medical Centre 



15 



which was to house the poor, the 
sick, infirm and the insane. This 
was without doubt the first large 
house or building in America, 
which performed the function of 
a hospital, and this system con- 
tinued until December 31, 1919. 
Upon this date, the almshouse, by 
legislative Act No. 274, Common- 
wealth, known as the New City 
Charter, was separated from the 
hospital, the former being trans- 
ferred to a new city department 
called the Department of Welfare. 
The Philadelphia General Hos- 
pital was continued under the De- 
partment of Health, Bureau of 
Hospitals. 

In English we have no equiva- 
lent to the French word "hospice" 
so that the word hospital has been, 
and is still used in the double 
sense, viz., as a place for medical 
treatment, and also as a retreat or 
almshouse for the poor, the in- 
firm, etc. 

It is not known who were the 
first physicians to attend the 
Philadelphia Almshouse. The de- 
struction of records through van- 
dalism, "the dust of ages," the 
"eating tooth of time" leaves us 
little information. There exists, 
however, a formal announcement, 
dated May 18, 1769, of the re-elec- 
tion of Drs. Cadwalder Evans and 
Thomas Bond. In 1759 Dr. Bond 
was 57 years of age, so it is very 
probable that he had served for a 
number of years previous to that 
date. Dr. Bond, having enjoyed 
the advantages of the Almshouse, 
felt it necessary to have a place 
where he could take his more af- 
fluent patients, where they could 
pay for the services rendered, and 
it was with this thought in mind 
that he was instrumental in start- 
ing the Pennsylvania Hospital in 
1752. 

Philadelphia physicians can, 
therefore, feel justly proud of hav- 
ing the first hospital in the United 
States started in Philadelphia, the 
first medical text-book published 
in America was printed in Phila- 
delphia and the first clinical medi- 
cal lecture was delivered in the 
City of Brotherly Love. 

By the year 1765 the applicants 
for admission had become so many 
at the Almshouse that there were 



not sufficient accommodations, and 
on February 8, 1766, an act was 
passed forming the Almshouse 
Corporation, and a lot of ground, 
bounded by Spruce, Pine, Tenth 
and Eleventh Streets, belonging to 
the widow Callender, was pur- 
chased for eight hundred pounds. 

The plans for a new building 
were agreed upon and on its com- 
pletion was opened in October, 
1767, and was known as the Alms- 
house, which had its infirmary and 
the House of Employment, often 
referred to as the Bettering House. 
This title was supposed to indicate 
that the house caused a betterment 
of the condition of the poor in- 
mates who were mere beggars and 
justified Dr. Agnew, who, in his 
history, stated that in some way 
the title is derived from the Ger- 
man "Bettler Haus." In time this 
name came to be used as a con- 
temptuous appellation. 

Some idea of the care taken of 
the sick may be had from the fol- 
lowing notes taken from the Jour- 
nal of the Reverend Manasseh 
Cutler, Volume 1, pages 253 to 285, 
written in 1787. Mr. Cutler had 
been out driving with Dr. Gerardus 
Clarkson, then a member of the 
hospital staff. "We returned to 
Philadelphia between ten and 
eleven o'clock. When we came to 
the hospital Dr. Clarkson left me 
and went into the city on his son's 
horse. Young Mr. Clarkson con- 
ducted me into the hospital (the 
young Mr. Clarkson referred to is 
in all probability the Dr. William 
Clarkson who later became a mem- 
ber of the staff. ) Dr. Rush arrived 
in a few minutes after. This build- 
ing is in the form, as you approach 
it from the city, of an inverted T. 
It is surrounded with a high wall, 
and has back of it a very large 
kitchen garden. The door in the 
center opens into a large hall. On 
each end are apartments for the 
nurses, cooks, etc. We ascended 
the stairway out of this hall into 
another hall in the second story, 
at one end of which is a large 
room, which contains a fine medi- 
cal library, where the Directors 
were sitting, and a smaller room 
where the medicine is placed. On 
the opposite .end are the apart- 
ments for the attending physicians. 



The third floor is formed in the 
same manner. On one side of this 
hall is the Museum, where there 
is a collection of skeletons and 
anatomies. 

"After we had taken a view of 
the Museum, we returned to the 
upper hall, where several physi- 
cians and all the young students in 
physics in the city were waiting. 
Dr. Rush then began his examina- 
tion of the sick, attended by these 
gentlemen, which I judged to be 
between twenty and thirty. We 
entered the upper chamber of the 
sick, which is the leg of the T. 
It is a spacious room finely venti- 
lated with numerous large win- 
dows on both sides. There were 
two tiers of beds with their heads 
towards the walls, and a small 
chair and a small table between 
them. The room was exceedingly 
clean and nice, the beds and 
bedding appeared to be of good 
quality, and the most profound 
silence and order were preserved 
upon the doctor's entering the 
room. There were only women, 
and about forty in number. Dr. 
Rush makes his visits with a great 
deal of formality. He is attended 
by the attending physicians, who 
give him an account of everything 
material since he saw them last, 
and by the apothecary of the hos- 
pital who minutes his prescrip- 
tions. We next took a view of the 
maniacs. Their cells are about ten 
feet square, made as strong as a 
prison. On the back part is a long 
entry, from which a door opens 
into each of them. From this dis- 
tressing view of what human na- 
ture is liable to, and the pleasing 
evidence of what humanity and 
benevolence can do, we returned 
to the room where the doctors 
were. The scene I had now been 
attending upon was totally the re- 
verse of at Gray's but such is the 
elegance of this building, the care 
and attention to the sick, the spa- 
cious and clean apartments and the 
perfect order in everything, that it 
seemed more like a palace than a 
hospital, and one would almost be 
tempted to be sick, if they could 
be so well provided for. We then 
took a view of the bettering house, 
which is a large and spacious 
building with good room and well 
furnished." 



•' « 



16 



PHILADELPHIA— World' s Medical Centre 



With the growth of the city new 
quarters had to be secured, and on 
January 1, 1829, the present site 
was purchased from Henry Beckett 
and his wife, Mary, for the sum of 
fifty-one thousand, five hundred 
and twenty-eight dollars and 
twelve and one-half cents, and 
there were erected buildings which 
were called, respectively, the Alms- 
house, House of Employment, Hos- 
pital and Children's Asylum. The 
building commissioners reported 
that two of these buildings would 
be ready for the inmates on Oc- 
tober 1, 1833. There is an admis- 
sion card in existence with the 
name of Mary Canon and the date 
August 22, 1833, which is supposed 
to have been the first card issued 
at the present location. 

In 1658 Captain Warner settled 
on the west bank of the Schuylkill 
River where he obtained posses- 
sion of an extensive tract of land 
to which he gave the name "Block- 
ley," in memory of the happy 
home in England which he was 
compelled to desert. Later this 
tract of land became known as 
Blockley Township and the name 
Blockley Almshouse was used in 
connection with the establishment. 

When first purchased, the prop- 
erty consisted of about 158 acres. 
This has been reduced by sales to 
various parties, so that today the 
hospital occupies only about one- 
tenth of the acreage. At the time 
the Act of Consolidation went into 
effect the Almshouse was under 
the control of a board known as 
the Board of Guardians of the 
Poor, one of which was selected by 
the voters of each ward. The 
Board then constituted was abol- 
ished by the Act of Assembly 
dated 1859, which directed that the 
Board of Guardians should there- 
after be appointed; three by the 
District Court; three by the Court 
of Common Pleas and three by the 
Common Council. By the Act of 
June 2, 1871, the election of the 
guardians was placed entirely with 
City Councils. The management of 
the Almshouse and hospital con- 
tinued under the Board of Guard- 
ians thus elected until the Act 
entitled "An Act to provide for 
the better government of cities of 
the first class of the Common- 
wealth," familiarly known as the 



Bullitt Bill, came into force on 
the first Monday of April, 1887. 
Under this Act, the executive 
power was invested in a Mayor and 
certain departments, one of which 
was known as the Department of 
Charities and Correction, which 
was under the charge of a presi- 
dent and four directors, to whom 
were confided the care, manage- 
ment, administration and super- 
vision of the Almshouse, Hospital, 
House of Correction and other 
similar institutions, the govern- 
ment of which was entrusted to 
the city, except the Municipal 
Hospital, the Lazaretto, and insti- 
tutions under any city trust then 
existing. Under the Bullitt Bill, 
the Board of Charities and Correc- 
tion was divided into two bureaus, 
one having charge of the Alms- 
nouses and the other the House of 
Correction. On April 8, 1903, the 
State Legislature passed an Act 
amending the Bullitt Bill, pro- 
viding for a Department of Public 
Health and Charities in lieu of the 
Department of Charities and Cor- 
rection. An Ordinance was passed 
putting into effect this Act of As- 
sembly after May 1, 1903. The 
almshouses, hospitals and allied in- 
stitutions were placed under the 
control of the new department, 
which had for its head a director. 
The House of Correction and other 
interests confided to the old Bu- 
reau of Correction were trans- 
ferred to the Department of Pub- 
lic Safety. In 1906, during the 
administration of Mayor John 
Weaver, 874 acres of ground was 
purchased at Byberry and since 
that date buildings have been 
erected. In 1914, the sum of $250,- 
000 was appropriated by City 
Council and $200,000 by the State 
of Pennsylvania for the construc- 
tion of a building for feeble- 
minded at Byberry. This building 
formed the nucleus of the present 
Philadelphia Hospital for Mental 
Diseases at Byberry. The Alms- 
house, by Legislature Act No. 374, 
an Act for the Better government 
of cities of the first class of this 
commonwealth, known as the New 
City Charter, was separated from 
the hospital, the former being 
transferred to a new city depart- 
ment called the Department of 
Welfare. The Philadelphia Gen- 
eral Hospital was continued under 



the Department of Health and the 
Bureau of Hospitals. For about a 
half a century, public opinion was 
gathering force and men in public 
life being informed of community 
needs, brought about renewed 
pressure for the rebuilding of the 
City Hospital. Beginning then, in 
1920, the Philadelphia General 
Hospital has metamorphosed from 
an old group of buildings, housing 
the indigent, the insane and the 
physically ill, into a great general 
hospital. In 1924, the sum of $4,- 
000,000 was appropriated as a re- 
sult of a loan for the rebuilding 
of the Philadelphia General Hos- 
pital, and on Monday, September 
21, 1925, work was begun and 
today we have a hospital which 
every citizen should feel exceeding 
proud, for in the Philadelphia 
General Hospital centers the 
growth of medicine in Philadel- 
phia, a growth as interesting to the 
searching mind as is the growth of 
a thought, the growth of a seed, 
as important contributions to 
medical literature have been made 
by men who have been members 
of the staff of the Philadelphia 
General Hospital; Gerhard and 
Pennock on the differential diag- 
nosis between typhus and typhoid 
fever; Osier on malaria; Stille on 
cholera and epidemic cerebro- 
spinal meningitis; Pepper and 
Parry on relapsing fever; Parrish 
on puerperal septicemia, and other 
contributions which have become 
almost classics in the history of 
the subjects which they discuss. 
These are only a few striking ex- 
amples of the great work done at 
the Philadelphia General Hos- 
pital; work that is not confined to 
material furnished from the do- 
main of which is commonly spoken 
of as general medicine and sur- 
gery, but every recognized medical 
specialty. Though the hospital 
today is known under its official 
name, the Philadelphia General 
Hospital, the medical men once 
connected with it call it "Block- 
ley," which to them is a term of 
endearment, the same as it was to 
Captain Warner. Well may the 
City of Brotherly Love be proud 
of its hospital, the oldest hospital 
in the United States and the finest 
of its kind. There it stands, a 
tribute to the spirit of the humani- 
tarian founder of the city. 



mined 



. 



PHILADELPHIA— World' s Medical Centre 



17 



On one occasion a number of 
years ago an old woman went to 
the Almshouse, under the influence 
of liquor. She wanted to be ad- 
mitted but the doctor who ex- 
amined her found that she did not 
require any medical treatment and 
refused to assign her to the sick 
ward. She became very indignant 
and exclaimed in a loud voice: 
"I'd have you to know that Mr. 
Blockley left his money for the 
benefit of us poor people and not 

for a lot of you d doctors and 

white caps." She applied the term 
"white caps" to the nurses in the 
hospital, and it is evident that she 
thought that Mr. Blockley was a 
man something like Stephen Gi- 
rard. 

The word Blockley was used in 
connection with a number of other 
institutions: The Blockley Baptist 
Church; Blockley Library, in the 
old Hestonville Hall; Blockley 
Post Office, in the antiquated store 
which stood at Lancaster and 
Paschal Streets, now Master Street; 
the Blockley Brass Band, after- 
wards called the Washington Cor- 
net Band. The old Lancaster Road 
was called, for many years, the 
Blockley and Merion Turnpike or 
Plank Road; a portion of what is 
now Sixty-third Street was called 
Blockley Avenue. 

Quoting from Sir William Osier : 
"This venerable institution origi- 
nally the Philadelphia Almshouse, 
which in 1742 was 'fulfilling a 
varied routine of beneficial func- 
tions,' has just claim to be the 
oldest hospital in the States. Hav- 
ing migrated twice during the 
growth of the city, it finally, in 
1834, moved from the 'Bettering 



House,' in what is now the heart 
of Philadelphia, to a farm in the 
suburbs in the then Township of 
Blockley on the west side of the 
Schuylkill. Here, far out in the 
country, the indigent poor and af- 
flicted, the alcoholic and insane of 
Philadelphia came to be housed — 
'went over the hills to the poor- 
house.' " 

The following notes are taken 
from the Hospital Records: 

In the year 1767 Dr. Gerardus 
was paid one pound, fourteen shill- 
ing for sundry medicines admin- 
istered to a poor woman. 

June, 1770, an order was drawn, 
payable to Dr. Bond and Cad- 
walder Evans, the two physicians 
of the institution, for fifty pounds 
each. 

January 3, 1771, notice being 
given to Dr. Bond, he attended 
this evening, when he was desired 
not to permit any pupils under his 
particular direction or any of 
those attending the Medical 
Schools in this city to be present 
at the delivery of the women in 
the said ward, but those who were 
of decent manners and suitable 
age to attend operations of that 
kind, which regulation the doctor 
heartily approved of, and that he 
would strictly observe the same. 

February 28, 1771, Dr. Evans 
agreed to vaccinate the children in 
the Almshouse who had not had 
smallpox, and to charge the insti- 
tution only with the medicine to 
be given. 

In 1790 the following physicians 
were on duty at the Almshouse: 
Drs. Samuel Powell Griffitts, John 
Morris, Samuel Duffield, William 
Clarkson, William Shippen, Cas- 



par Wistar, Michael Leib and 
Nathan B. Waters. 

During the month of August, 
1807, an epidemic of influenza 
broke out in the house, attacking 
both officers and inmates and pre- 
vailing in so violent a form and so 
general as to interrupt the ordi- 
nary routine of business. 

Previous to 1839, the resident 
physicians paid the sum of $250.00 
for the privilege of serving in the 
hospital for the term of one year; 
during this year the price was re- 
duced to $125.00 and $50.00 was 
charged for their board. 

One person not a physician 
whose name stands out in bold re- 
lief in Blockley History is "Daddy" 
Owens. On December 7, 1909, a 
bronze tablet in his memory was 
placed in position on the wall of 
the corridor of the men's medical 
floor. The following is a copy of 
the inscription thereon: 

To The Memory of 

THOMAS J. OWENS 

1838 1908 

For Thirty Years Head Nurse of 

The Men's Medical Floor of The 

Philadelphia General Hospital 

Erected By His Friends 

The Ex-resident Physicians 

November, 1909 

The term "Resident Physicians" 
was formerly used to apply to all 
physicians residing in the hospital. 
In recent years this term has been 
used to describe physicians who 
have supervisory duties, and are 
paid a salary, and the word "In- 
terne" is descriptive of the recent 
graduate in medicine, who is un- 
paid. 




'■ -''Vv.-""~ 



18 



PHILADELPHIA— World's Medical Centre 



' 



Reminiscences From the Early Days of the 

Pennsylvania Hospital 






By EDWARD A. STRECKER, M.D. 
PHILADELPHIA, PA. 



IN this day of jazz, cubism, fu- 
turism and individualism, his- 
torical monuments are not apt 
to be overwhelmed by attention. 
Furthermore, it is axiomatic that 
"the prophet is without honor in 



in order that "they may be re- 
stored to reason and become use- 
ful members of the community." 
It was principally out of considera- 
tion for those unfortunate beings 
who through loss of reason had be- 



which when completed in 1756 
provided better accommodations. 
That the needs of the mentally 
sick were constantly in the minds 
of the Managers was evidenced by 
constant improvements in housing 




PENNSYLVANIA HOSPITAL FOR MENTAL DISEASES 

(Kirkbride's) 
Market Street, Forty-fourth to Forty-ninth 



his own land" and it is a common 
observation that we travel thou- 
sands of miles to stand on the sa- 
cred soil of history while at the 
same time we may be blissfully 
unaware of the historical wealth 
which is at our very doors. 

How many of us realize that our 
own Pennsylvania Hospital is the 
cradle of American Psychiatry? 
The principal motive which had 
inspired the founders of the Penn- 
sylvania Hospital as well as the 
main argument expressed in the 



petition to the Provincial Assem- 
bly afterwards embodied in the 
Act of May 11, 1751, was "the 
cure and treatment of lunaticks," 
come "a terror to their neighbors," 
and for whom no adequate provi- 
sion had hitherto been made, that 
the Managers felt the necessity of 
providing, temporarily, the build- 
ing known as Judge Kinsey's Man- 
sion, for hospital purposes. Of the 
two patients who were admitted 
on the first day after the doors 
were opened February 11, 1752, 



one was a "lunatick" recom- 
mended by the Visitors of the 
Poor of the City. 

It soon became obvious that the 
apartments provided for the in- 
sane were in the language of that 
day "not convenient" and in 1755 
building operations were begun, 
conditions, which in 1835 culmi- 
nated in the following resolution: 
"Resolved, that in the opinion of 
this meeting it is expedient that 
the Lunatic department of the 
Pennsylvania Hospital should be 



i 



— 



PHILADELPHIA— World's Medical Centre 



19 



removed from the City of Phila- 
delphia to the country in its vicin- 
ity, provided that the removal can 
be effected upon such a plan as 
will promote the comfort and im- 
prove the health of the patients 
and admit of the superintendence 
and control essential to a good ad- 
ministration of the institution." 

The corner-stone of the building 
which now stands at 44th and Mar- 
ket Streets was laid on July 22, 
1836, and for many years this 
building was the model for mental 
hospitals all over the world. It 
may not be beside the mark to 
mention that on September 17, 
1928, ground was broken at 49th 
and Market Streets for the erection 
of a modern and scientific Psychia- 
tric Institute. 

It is interesting to note that at 
as early a date as 1756, almost 
forty years before Pinel began to 
preach his doctrine of humanita- 
rianism, the Pennsylvania Hospi- 
tal had provided for the insane 
not only extensive grounds, but 
also "a gallery eighty feet in 
length for such of them as may be 
trusted to walk about, with a place 
for bathing." 

The therapeutics of those early 
days was complicated and decid- 
edly unpleasant for the unfortu- 
nate patient." The medical treat- 
ment appears to have been di- 
rected principally to the acute or 
sthenic forms of lunacy, or cases 
of so-called Phrenzy. These were 
douched or played upon with 
warm and cold water; their scalps 
were shaved and blistered; they 
were bled to the point of syncope; 
purged until the alimentary canal 
failed to yield anything, but mu- 
cus, and, in the intervals, they 
were chained by the waist or the 
ankle to the cell wall. Under 
this heroic regimen, some, prob- 
ably the most sthenic, recovered 
their reason. There appears noth- 
ing in the records to indicate any 
special mode of treatment for mel- 
ancholia, or for the stuporous 
forms of mental disorder. Later 
there were mentioned certain spe- 
cial appliances for rousing such 
patients, which, judging from the 
description, must have, tempora- 
rily, at least, effected the desired 
object." 



Restraint was freely utilized. 
For instance, an account of March 
7, 1752, read as follows: "John 
Cresson, blacksmith, against ye 
hospital, 1 pair of handcuffs, 2 legg 
locks, 2 large rings and 2 large 
staples, 5 links and 2 large rings 
and 2 swiffells for legg chains. 
To 3 locks, 13 keys, chains and 
staples for cells Ll.10.3 5th Mo. 
25th, 1752. On 5th Mo. 1754 Paid 
for 7 yds. of Ticken for Mad 
Shirts, L0.16.4i/ 2 ." 

To those of us who lose our tem- 
pers if a Wassermann report or a 
blood count is delayed several 
hours, it may be salutary to recall 
that in the days of which I am 
speaking the Managers and Physi- 
cians were concerned with more or 
less and principally with less suc- 
cessful attempts to protect the pa- 
tients from rats and to furnish 
them with heat and light. The 
cells for the insane were without 
adequate heat for almost 80 years, 
until 1833. In this connection the 
historian of that day observes 
that "The insane were not sup- 
posed to require, nor to quite de- 
serve, the usual comforts of life 
at this period, when even the sane 
dwelt in cold houses, slept in cold 
apartments, and sat through the 
long winter evenings by candle or 
fire light." 

The formalities of admission 
were exceedingly simple. There 
was little required beyond the ap- 
plication of a friend or, as has 
been noted in the history of the 
hospital, an enemy of the patient, 
to one of the Managers or Physi- 
cians. The informality of the day 
may be expressed by quoting a few 
of the records of admission — "Dr. 
Moore's Negro man, a lunatick 
was received 3rd. Mo. 26th, 1753. 
His master promised payment. 
1st. Mo. 23rd. 1754. Admitted 
Negro Adam, a Lunatick and pay 
patient belonging to Mrs. Mar- 
garet Clymer, under the care of 
Dr. Thos. Bond. 2nd. Mo. 16th, 
1754. Black Adam, at ye request 
of his Mistress Margaret Clymer, 
was this day discharged. 6th. Mo. 
26th, 1754. Admitted Negro 
George, a Lunatick belonging to 
Mr. Carrington of Barbadoes, a 
pay patient at 10s a week, under 
ye particular care of Doctor Ship- 
pen who engages for his board." 



It may be worth while and in- 
teresting to quote from the earlier 
records and minutes: 

"May 10th, 1762. The great 
crowds that invaded the Hospital 
give trouble and create so much 
disturbance, that Samuel Rhoades 
and Jacob Lewis are directed to 
employ a workman to make a suit- 
able hatch door and get an in- 
scription thereon notifying that 
such persons who come out of curi- 
osity to visit the house should pay 
a sum of money, a Groat at least, 
for admittance." 

Later, this rule seems to have 
fallen into disuse, as, on April 27, 
1767: 

"Orders were renewed that the 
Hatch door be kept carefully shut 
and that no Person be admitted 
into the House without paying the 
gratuity of Four Pence formerly 
agreed upon, and that care be 
taken to prevent the Throng of 
people who are led by Curiosity 
to frequent the House on the first 
day of the week, to the great dis- 
turbance of the Patients." 

From time to time other meas- 
ures had to be taken to preserve 
order. On August 30, 1784: 

"Dr. Foulke recommended that 
some regulations may be made in 
respect to persons visiting the Hos- 
pital, particularly in adopting such 
Rules as would tend to preserve 
the Lunatic Patients from being 
interrupted and disturbed in their 
course of Medicine. Ordered that 
the Sitting Managers consult with 
as many of the Physicians as they 
conveniently can and report such 
rules and regulations at our next 
Stated Meeting as will be most con- 
ducive to remedy any present Evil 
on that head which may now ex- 
ist." 

Whereupon, on October 4, 1784: 
"They Reported that they had 
found it useful in adopting the fol- 
lowing regulations respecting the 
Lunatic Patients : viz : The putting 
up an Advertisement or Rule for- 
bidding more than two Persons at 
one time to be permitted to go into 
the Cells and those Persons to be 
attended by the Cell-Keeper and 
not suffered to speak to such Pa- 
tients." 



T*l*> . Millie- ■'